Top

The Journal of Behavioral Health Services & Research

Published in:

01-04-2008 | Regular Article

Development and Validation of Short Versions of the Internal Mental Distress and Behavior Complexity Scales in the Global Appraisal of Individual Needs (GAIN)

Authors: Janet C. Titus, PhD, Michael L. Dennis, PhD, Richard Lennox, PhD, Christy K. Scott, PhD

Published in: The Journal of Behavioral Health Services & Research | Issue 2/2008

Abstract

Co-occurring mental distress and behavior problems are the norm in substance abuse treatment but are often poorly assessed due to resource constraints. This paper describes the development and validation of scales measuring internalizing mental distress and externalizing behavior problems that are shorter versions of comorbidity scales found in the full Global Appraisal of Individual Needs (GAIN). GAIN data from two treatment outcome studies, one involving adolescents and the other on adults, were used in the creation and testing of the scales. Subsets of items from the full GAIN scales were selected for the short scales through the application of standard psychometric principles. The short comorbidity scales still have moderate to high reliability and are highly correlated with the full scales. Parallel tests of construct validity show no substantial loss when moving from the longer to shorter versions. The short scales maintain good sensitivity and specificity for predicting diagnostic impressions.

Regier DA, Farmer ME, Rae DS, et al. Comorbidity of mental disorders with alcohol and other drug abuse: Results from the Epidemiologic Catchment Area (ECA) study. Journal of the American Medical Association. 1990;264:2511–2518.PubMedCrossRef

Kessler RC, Chiu WT, Demler O, et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry. 2005;62(6):617–627.PubMedCrossRef

Enns MW, Swenson JR, McIntyre RS, et al. Clinical guidelines for the treatment of depressive disorders. VII. Comorbidity. Canadian Journal of Psychiatry. 2001;46:77–90.

Chan Y, Dennis ML, Funk RR. Prevalence and comorbidity of major internalizing and externalizing problems among adolescents and adults presenting to substance abuse treatment. Journal of Substance Abuse Treatment. 2008;34(1):14–24.PubMedCrossRef

Dembo R. Problems among youths entering the juvenile justice system, their service needs and innovative approaches to address them. Substance Use and Misuse. 1996;31:81–94.PubMedCrossRef

Deykin EY, Levy JC, Wells V. Adolescent depression, alcohol, and drug abuse. American Journal of Public Health. 1987;77:178–182.PubMedCrossRef

Diamond G, Panichelli-Mindel SM, Shera D, et al. Psychiatric syndromes in adolescents seeking outpatient treatment for marijuana with abuse and dependency in outpatient treatment. Journal of Child and Adolescent Substance Abuse. 2006;15:37–54.CrossRef

Dennis ML, Scott CK, Funk R. An experimental evaluation of recovery management checkups (RMC) for people with chronic substance use disorders. Evaluation and Program Planning. 2003;26:339–352.CrossRef

Dennis ML, Scott CK. Managing addiction as a chronic condition. Journal of Addiction Science and Clinical Practice. 2007;4(1):45–55.CrossRef

10.

Titus JC, Dennis ML, White WL, Scott CK, Funk RR. Gender differences in victimization severity and outcomes among adolescents treated for substance abuse. Journal of Child Maltreatment. 2003;8(1):19–35.CrossRef

11.

Wilsnack SC, Vogeltanz ND, Klassen AD, et al. Childhood sexual abuse and women’s substance abuse: National survey findings. Journal of Studies on Alcohol. 1997;58:264–271.PubMed

12.

Achenbach TM, Edelbrock CS. The Child Behavior Profile: II, boys aged 12–16 and girls aged 6–11 and 12–16. Journal of Consulting and Clinical Psychology. 1979;47:223–233.PubMedCrossRef

13.

Kessler RC, Adler L, Barkley R, et al. The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication. American Journal of Psychiatry. 2006;163:716–713.PubMedCrossRef

14.

Flynn PM, Kristiansen PL, Porto JV, et al. Costs and benefits of treatment for cocaine addiction in DATOS. Drug and Alcohol Dependence. 1999;57:167–174.PubMedCrossRef

15.

Babor TF, Webb CPM, Burleson JA, et al. Subtypes for classifying adolescents with marijuana use disorders: Construct validity and clinical implications. Addiction. 2002;97:58–69.PubMedCrossRef

16.

Brooner RK, Greenfield L, Schmmidt CW, et al. Antisocial personality disorder and HIV infection among intravenous drug abusers. American Journal of Psychiatry. 1993;150:53–58.PubMed

17.

Richter L, Johnson PB. Current methods of assessing substance use: A review of strengths, problems, and developments. Journal of Drug Issues. 2001;31:809–832.

18.

Tims FM, Leukefeld CG, Platt JJ (eds). Relapse and Recovery in Addictions. New Haven: Yale University Press; 2001.

19.

Weisner C, McLellan T, Barthwell A, et al. Report of the Blue Ribbon Task Force on Health Services Research at the National Institute on Drug Abuse. Rockville, MD: National Institute on Drug Abuse; 2004.

20.

McLellan AT, Carise D, Kleber HD. Can the national addiction treatment infrastructure support the public’s demand for quality care? Journal of Substance Abuse Treatment. 2003;25:117–121.PubMedCrossRef

21.

Substance Abuse and Mental Health Services Administration. Report to Congress on the Prevention and Treatment of Co-Occurring Substance Abuse Disorders and Mental Disorders. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2002.

22.

Center for Substance Abuse Treatment. Substance Abuse Treatment for Persons with Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series 42, DHHS Pub. No. (SMA) 05-3992. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2005.

23.

Dennis ML, Titus JC, Diamond G, et al. The Cannabis Youth Treatment (CYT) experiment: Rationale, study design, and analysis plans. Addiction. 2002;97:S16–S34.CrossRef

24.

Dennis M, Godley SH, Diamond G, et al. The Cannabis Youth Treatment (CYT) Study: Main Findings from Two Randomized Trials. Journal of Substance Abuse Treatment. 2004;27(3):197–213.PubMedCrossRef

25.

Scott CK, Foss MA, Dennis ML. Utilizing Recovery Management Checkups to shorten the cycle of relapse, treatment reentry, and recovery. Drug and Alcohol Dependence. 2005;78:325–338.PubMedCrossRef

26.

Dennis ML, Titus JC, White MK, et al. Global Appraisal of Individual Needs: Administration Guide for the GAIN and Related Measures. Bloomington, IL: Chestnut Health Systems, 2003. Available at: http://www.chestnut.org/li/gain.

27.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) (4th—text revision ed.). Washington, DC: American Psychiatric Association; 2000.

28.

American Society of Addiction Medicine (ASAM). Patient Placement Criteria for the Treatment for Substance-Related Disorders. 2nd edn. Chevy Chase, MD: American Society of Addiction Medicine; 2001.

29.

Godley MD, Godley SH, Dennis ML, et al. Preliminary outcomes from the assertive continuing care experiment for adolescents discharged from residential treatment. Journal of Substance Abuse Treatment. 2002;23:21–32.PubMedCrossRef

30.

Shane P, Jasiukaitis P, Green RS. Treatment outcomes among adolescents with substance abuse problems: The relationship between comorbidities and post-treatment substance involvement. Evaluation and Program Planning. 2003;26:393–402.CrossRef

31.

Dennis ML, Chan Y, Funk R. Development and validation of the GAIN Short Screener (GSS) for internalizing, externalizing, and substance use disorders and crime/violence problems among adolescents and adults. The American Journal on Addictions. 2006;15:1–12.PubMedCrossRef

32.

Derogatis LR, Lipman RS, Rickels K, et al. The Hopkins symptom checklist (HSCL): A self-report symptom inventory. Behavioral Science. 1974;19:1–15.PubMedCrossRef

33.

Keane TM, Caddell JM, Taylor KL. Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: Three studies in reliability and validity. Journal of Consulting and Clinical Psychology. 1988;56:83–90.CrossRef

34.

King DW, King LA, Fairbank JA, et al. Enhancing the precision of the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: An application of item response theory. Psychological Assessment. 1993;5:457–471.CrossRef

35.

Vreven DL, Gudanowski DM, King LA, et al. The civilian version of the Mississippi PTSD scale: A psychometric evaluation. Journal of Traumatic Stress. 1995;8:91–109.PubMed

36.

Lauterbach D, Vrana S, King DW, et al. Psychometric properties of the civilian version of the Mississippi PTSD Scale. Journal of Traumatic Stress. 1997;10:499.PubMed

37.

Strauss MA. Conflict Tactic Scale. In: Strauss MA, Gelles RJ (eds). Physical Violence in American Families: Risk Factors and Adaptions to Violence in 8,145 Families. Durham, NH: University of New Hampshire, 1990.

38.

Federal Bureau of Investigations. 1993 Uniform Crime Reports. 1994. Available at http://www.fbi.gov/ucr. OAS 11995.

39.

Office of Applied Studies. National Household Survey on Drug Abuse (NHSDA). Rockville, MD: Substance Abuse and Mental Health Services Administration; 1995.

40.

Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297–334.CrossRef

41.

Cronbach LJ. The Dependability of Behavioral Measurement: Theory of Generalizability for Scores and Profiles. New York: John Wiley & Sons; 1972.

42.

Bollen K, Lennox R. Conventional wisdom on measurement: A structural equation perspective. Psychological Bulletin. 1991;110:305–314.CrossRef

43.

Nunnally JC, Bernstein IH (eds). Psychometric Theory. McGraw-Hill: New York; 1994.

44.

Cronbach LJ, Meehl PE. Construct validity in psychological tests. Psychological Bulletin. 1955;52:281–302.CrossRef

45.

Lennox RD, Scott-Lennox JA, Bohling EM. The cost of depression-complicated alcoholism: Health care utilization and treatment effectiveness. The Journal of Mental Health Administration. 1993;20(2):138–152.CrossRef

46.

Campbell DT, Fiske DW. Convergent and discriminant validation by the multi-trait-multi-method matrix. Psychological Bulletin. 1959;56:81–105.PubMedCrossRef

Title: Development and Validation of Short Versions of the Internal Mental Distress and Behavior Complexity Scales in the Global Appraisal of Individual Needs (GAIN)
Authors: Janet C. Titus, PhD
Michael L. Dennis, PhD
Richard Lennox, PhD
Christy K. Scott, PhD
Publication date: 01-04-2008
Publisher: Springer US
Published in: The Journal of Behavioral Health Services & Research / Issue 2/2008
Print ISSN: 1094-3412
Electronic ISSN: 2168-6793
DOI: https://doi.org/10.1007/s11414-008-9107-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Development and Validation of Short Versions of the Internal Mental Distress and Behavior Complexity Scales in the Global Appraisal of Individual Needs (GAIN)

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2008

Challenges Substance Abuse Treatment Agencies Faced in Adoption of Computer-Based Technology to Improve Assessment

Mindless Eating: Why We Eat More Than We Think, Brian Wansink, Ph.D.

Racial and Ethnic Disparities in the Use of Mental Health Services

Influences on Practitioner Treatment Selection: Best Research Evidence and Other Considerations

Employment Outcomes in a Randomized Trial of Second-Generation Antipsychotics and Perphenazine in the Treatment of Individuals with Schizophrenia

A Spatial Needs Assessment of Indigent Acute Psychiatric Discharges in California